Leonard Cottrell v. Alcon Laboratories

874 F.3d 154, 2017 WL 4657402, 2017 U.S. App. LEXIS 20341
CourtCourt of Appeals for the Third Circuit
DecidedOctober 18, 2017
Docket16-2015
StatusPublished
Cited by192 cases

This text of 874 F.3d 154 (Leonard Cottrell v. Alcon Laboratories) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Leonard Cottrell v. Alcon Laboratories, 874 F.3d 154, 2017 WL 4657402, 2017 U.S. App. LEXIS 20341 (3d Cir. 2017).

Opinions

OPINION OF THE COURT

RESTREPO, Circuit Judge

In this putative class action, consumers of prescription eye medication allege that manufacturers and distributors of the medication packaged it in such a way that forced them to waste it, violating the consumer protection statutes of their home states. The District Court dismissed the entire action for lack of jurisdiction, finding the consumers’ allegations of injury in fact insufficient to confer standing. For the reasons that follow, we will reverse the dismissal, and remand the case for further consideration.

I1

Defendants are manufacturers and distributors of generic and brand-name prescription eye drop tetedications that áre approved by the Food and Drug Administration (“FDA”) to treat serious medical conditions such as glaucoma, a leading cause of blindness.2 Defendants sell these prescription medications in fluid form and package the fluid in plastic bottles. Bottles are pre-packaged with a fixed volume of medication (e.g., 5.0 mL) sold at set prices. Labeling on the bottles does not indicate how many doses or days of treatment a patient will be able to extract from the bottle.

Medication is dispensed from the plastic bottles into patients’ eyes in drop form. The dimensions of the bottle’s dropper tip dictate the size of the drop dispensed from that bottle, In effect, the larger the bottle dropper tip, the larger the drop dispensed. There is no reasonable way for a patient to instill less than one full drop into his or her eye,

A- plethora of scientific research conducted over the last four decades has examined the drop size of Defendants’ medications; some of the studies conducted were, in fact, sponsored and published by Defendants. According to these studies, a normal adult’s inferior fornix—the area between‘the eye and the lower eyelid—has a capacity of approximatély 7 to 10 microliters (“p,Ls”) of fluid.3 If a drop of medication exceeding that capacity is placed into an adult patient’s eye, excess medication is expelled. Expelled medication may run down a patient’s cheek, providing no pharmaceutical benefit to the patient whatsoever. This medication is “entirely wasted” by the patient. App. 182. Expelled medication also may flow into a patient’s tear ducts and move into his or her bloodstream. Medication entering a patient’s bloodstream may increase a patient’s risk of experiencing certain harmful systemic side effects.

These studies conclude that eye drops should be 5 to 15 (xLs in order to maximize the amount of the medication entering the inner eye—the site of action for the medication. Drop sizes within this range minimize overflow “waste” and also minimize the risk of side effects.

Despite the scientific consensus on drop size, all of Defendants’ products at issue emit drops that are considerably larger than 15 p,Ls. In fact, a 2008 study showed that each Defendant’s drop size was more than two to three times the 15 p,L maximum recommended size. Several Defendants sold products with drop sizes of 50 |xL. To put these data in perspective, at least half of every drop of medication dispensed from any one of Defendants’ product bottles goes to waste on a patient, and may put the patient at risk of side effects.

Plaintiffs in this litigation are individuals who paid for Defendants’ eye drop medication. They allege that Defendants have control over the design and dimensions of the bottle dropper tip, and thus could reduce the size of drops emitted from their product bottles, but have chosen not to do so. Plaintiffs do not purport to have personal knowledge as to why no defendant has reduced their products’ drop sizes. However, Plaintiffs include in the Amended Complaint allegations that senior executives at Defendant Alcon explained to a consultant working with them that they were unwilling to reduce drop sizes because if they did, the company “would sell less product and make less money.” App. 244.

Plaintiffs aver that Defendants’ practices of selling medication in bottles that emit such large drops caused them “substantial” economic injury. App. 214. Specifically, Plaintiffs allege, “If the sizes of Defendants’ prescription eye drops were limited to the maximum effective size of 15 |xL ... the medication in the bottles would last longer and [Plaintiffs] would spend substantially less on their therapy than they do with larger, substantially wasted, eye drops.” App. 214. Plaintiffs illustrated this point in their Amended Complaint with an example provided in a 2008 scientific study:

[T]he average drop size for Allergan’s glaucoma drug Alphagan P ... in a 5 mL bottle was 43 |xL.... At the recommended dose of one drop in each affected eye three times daily, a 5 mL bottle would last a patient with bilateral glaucoma 20 days. That patient would go through 18.25 bottles in a year. In July 2013, a 5 mL bottle of Alphagan P ... cost $104.99. A year’s course of treatment would therefore cost approximately $1,915. However, approximately 65% of the medication, the amount over 15 jjlL, would be wasted. If the drops had been only 15 |xL, the patient would have needed only 6.46 bottles a year, or 7.0 bottles if the drops had been 16 |xL.... The unneeded medication would cost the patient more than $1,100 a year.

App. 215-216 (emphasis added). Plaintiffs also quantified their individual economic injuries in charts attached to the Amended Complaint.

Plaintiffs claim they could not have avoided these economic injuries; they were “compelled] [by Defendants’ practices] to spend more money on their therapy than if the drops were 15 (xL.” App. 214. They had no non-pharmaceutical alternative treatments for their conditions. And there were no alternative products to Defendants’; “all prescription eye drops are substantially larger than 15 |xL and therefore lead to wastage.” App. 217. Their only alternative was to forgo treatment and risk blindness or worsening eyesight.

II

In September 2014, Plaintiffs filed a putative class action complaint, on behalf of themselves and other similarly situated parties, in the United States District Court for the District of New Jersey. Plaintiffs asserted violations of the consumer protection laws of their respective home states: the New Jersey Consumer Fraud Act (“NJCFA”), N.J.SA. § 56:8-1, et seq.; the California Unfair Competition Law (“UCL”), Cal. Bus. Prof. Code § 17200, et seq.; the Florida Deceptive and Unfair Trade Practices Act (“FDUTPA”), Fla. Stat. § 501.201, et seq.; the Illinois Consumer Fraud Act (“ICFA”), 815 ILCS 505/1, et seq.; the North Carolina Unfair and Deceptive Trade Practices Act (“NCUDTPA”), N.C.G.S. § 75-1.1, et seq.; and the Texas Deceptive Trade Practices Act (“DTPA”), Tex. Bus. & Com. Code § 17.41, et seq. Plaintiffs claimed Defendants’ practices in manufacturing and selling prescription eye drop medication violated the statutes’ prohibitions on unfair or unconscionable trade practices. The District Court dismissed Plaintiffs’ original complaint for lack of standing, without prejudice to Plaintiffs’ ability to amend the complaint and cure the standing deficiencies.

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874 F.3d 154, 2017 WL 4657402, 2017 U.S. App. LEXIS 20341, Counsel Stack Legal Research, https://law.counselstack.com/opinion/leonard-cottrell-v-alcon-laboratories-ca3-2017.